尊严死教育在ICU临终患者疗护中的应用

Implementation of Death with Dignity Education in ICU Terminal Stage Patients

目的探讨尊严死教育在ICU临终患者中应用的效果。方法比较尊严死教育实施前后患者临终前治疗的选择,心肺复苏实施次数以及患者家属的满意度;并比较临终关怀治疗组和积极治疗组两组患者的死亡质量、临终前治疗的时间、治疗费用的差异。结果对临终患者家属进行尊严死教育后,临终前选择积极治疗患者比例较前明显下降(P<0.01),选择临终关怀治疗的患者比例明显升高(P<0.01),临终患者平均心肺复苏次数减少(P<0.01),患者家属满意率无统计学差异(P=0.17);和临终前积极治疗患者相比,选择临终治疗的患者临终前治疗时间缩短(P<0.01),治疗费用降低(P<0.01),死亡质量较高(P=0.01)。结论在ICU临终患者的家属中开展尊严死教育能够让更多临终患者的家属选择临终关怀治疗,实现患者尊严死,减少无效治疗。

Objective： To determine the effects of implementation of death with dignity education in ICU terminal stage patients. Methods： The rate of choosing palliative care and continuing intensive care, cardiopulmonary resuscitation （CPR） times and satisfaction of family members were compared between before and after implementation of death with dignity education; The therapeutic time and cost, the quality of death were compared between two groups of patients. Results： After implementation the education in the family members, more of them chose palliative care （55.5% vs 22.8%, P＜0.01）, the terminal stage patients received less CPR（P＜0.01）. To compare with the patients who chose continuing intensive care, the the patients who chose palliative care had higher quality of death（P=0.01）, shorted the time of treating in the ICU before death（P＜0.01）, cost less（P＜0.01）. Conclusion： Implementation of death with dignity education in the ICU makes more family members chose palliative care to treat their dying patients, and improved the quality and dignity of death in ICU.